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Abstract

Most endometrial polyps appear to originate from localized hyperplasia of the basalis, although their pathogenesis is not well understood. Polyps occur over a wide age range, but are most common in women in the fourth and fifth decades, becoming less frequent after age 60.1–3 Usually they present with abnormal uterine bleeding.4 They have been implicated as a cause of abnormal bleeding in between 2 % and 23% of patients coming to biopsy.2,5–7 They also have been implicated as a possible cause of infertility, either by physically interfering with blastocyst implantation or by altering the development of secretory phase endometrium, making it less receptive to the implanting embryo.8–11 A few endometrial polyps have been found in patients receiving tamoxifen therapy for breast carcinoma.12,13 Large polyps that extend into the endo-cervix and dilate the internal os can cause endometritis.

Keywords

Hyperplastic Polyp Endometrial Polyp Large Polyp Normal Endometrium Lower Uterine Segment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Kurman RJ, Mazur MT: Benign diseases of the endometrium. In: Blaustein’s Pathology of the Female Genital Tract. 4th ed. Kurman RJ, ed. New York: Springer-Verlag, 1994;367–409.CrossRefGoogle Scholar
  2. 2.
    Van Bogaert L-J: Glinicopathologic findings in endometrial polyps. Obstet Gynecol 1988;71: 771–773.PubMedGoogle Scholar
  3. 3.
    Peterson WF, Novak ER: Endometrial polyps. Obstet Gynecol 1956;8:40–49.PubMedGoogle Scholar
  4. 4.
    Schlaen I, Bergeron G, Ferenczy A, Wong P, Naves A, et al: Endometrial polyps: A study of 204 cases. Surg Pathol 1988;1:375–382.Google Scholar
  5. 5.
    Loffer FD: Hysteroscopy with selective endometrial sampling compared with D&G for abnormal uterine bleeding. The value of a negative hystero-scopic view. Obstet Gynecol 1989;73:16–20.PubMedGoogle Scholar
  6. 6.
    Schindler AE, Schmidt G: Post-menopausal bleeding: A study of more than 1000 cases. Maturitas 1980;2:269–274.PubMedCrossRefGoogle Scholar
  7. 7.
    Ghoo YG, Mak KG, Hsu G, Wong TS, Ma HK: Postmenopausal uterine bleeding of nonorganic cause. Obstet Gynecol 1985;66:225–228.Google Scholar
  8. 8.
    Dallenbach-Hellweg G: The endometrium of infertility. A review. Pathol Res Pract 1984; 178: 527–537.PubMedCrossRefGoogle Scholar
  9. 9.
    Wallach EE: The uterine factor in infertility. Fertil Steril 1972;23:138–158.PubMedGoogle Scholar
  10. 10.
    Foss BA, Home HW, Hertig AT: The endometrium and sterility. Fertil Steril 1958;9:193–206.PubMedGoogle Scholar
  11. 11.
    Sillo-Seidl G: The analysis of the endometrium of 1,000 sterile women. Hormones 1971;2:70–75.PubMedCrossRefGoogle Scholar
  12. 12.
    Nuovo MA, Nuovo GJ, McCaffrey FM, Levine RU, Barron B, et al: Endometrial polyps in postmenopausal patients receiving tamoxifen. Int J Gynecol Pathol 1989;8:125–131.PubMedCrossRefGoogle Scholar
  13. 13.
    Corley D, Rowe J, Curtis MT, Hongan WM, Noumoff JS, et al: Postmenopausal bleeding from unusual endometrial polyps in women on chronic tamoxifen therapy. Obstet Gynecol 1992;79:111–116.PubMedGoogle Scholar
  14. 14.
    Dinh TV, Slavin RE, Bhagavan BS, Hannigan EV, Timason EM, et al: Mixed mullerian tumors of the uterus. A clinicopathologic study. Obstet Gynecol 1989;74:388–392.PubMedGoogle Scholar
  15. 15.
    Salm R: The incidence and significance of early carcinomas in endometrial polyps. J Pathol 1972; 108:47–53.PubMedCrossRefGoogle Scholar
  16. 16.
    Wolfe SA, Mackles A: Malignant lesions arising from benign endometrial polyps. Obstet Gynecol 1962;20:542–550.PubMedCrossRefGoogle Scholar
  17. 17.
    Silva EG, Jenkins R: Serous carcinoma in endometrial polyps. Mod Pathol 1990;3:120–128.PubMedGoogle Scholar
  18. 18.
    Kahner S, Ferenczy A, Richart RM: Homologous mixed mullerian tumors (carcinosarcoma) confined to endometrial polyps. Am J Obstet Gynecol 1975;121:278–279.PubMedGoogle Scholar
  19. 19.
    Barwick KW, Livolsi VA: Heterologous mixed mullerian tumor confined to an endometrial polyp. Obstet Gynecol 1979;53:512–514.PubMedGoogle Scholar
  20. 20.
    Silverberg SG, Major FJ, Blessing JA, Fetter B, Askin FB, et al: Carcinosarcoma (malignant mixed mesodermal tumor) of the uterus. A Gynecologic Oncology Group pathologic study of 203 cases. Int J Gynecol Pathol 1990;9:1–19.PubMedCrossRefGoogle Scholar
  21. 21.
    Pettersson B, Adami H-O, Lindgren A, Hesselius I: Endometrial polyps and hyperplasia as risk factors for endometrial carcinoma. A case-control study of curettage specimens. Acta Obstet Gynecol Scand 1985;64:653–659.PubMedCrossRefGoogle Scholar
  22. 22.
    Armenia GS: Sequential relationship between endometrial polyps and carcinoma of the endometrium. Obstet Gynecol 1967;30:524–529.PubMedGoogle Scholar
  23. 23.
    Gray LA, Robertson RW, Jr, Ghristopherson WM: Atypical endometrial changes associated with carcinoma. Gynecol Oncol 1974;2:93–100.PubMedCrossRefGoogle Scholar
  24. 24.
    Fraser IS: Hysteroscopy and laparoscopy in women with menorrhagia. Am J Obstet Gynecol 1990;162:1264–1269.PubMedGoogle Scholar
  25. 25.
    Dallenbach-Hellweg G: Histopathology of the Endometrium. 4th ed. New York: Springer-Verlag, 1987.CrossRefGoogle Scholar
  26. 26.
    Silverberg SG, Kurman RJ: Tumors of the uterine corpus and gestational trophoblastic disease. Atlas of Tumor Pathology, 3rd series, Fascicle 3. Washington, DC: Armed Forces Institute of Pathology, 1992.Google Scholar
  27. 27.
    Buckley CH, Fox H: Biopsy Pathology of the Endometrium. New York: Raven Press, 1989.Google Scholar
  28. 28.
    Mazur MT: Atypical polypoid adenomyomas of the endometrium. Am J Surg Pathol 1981;5: 473–482.PubMedCrossRefGoogle Scholar
  29. 29.
    Young RH, Treger T, Scully RE: Atypical polypoid adenomyoma of the uterus. A report of 27 cases. Am J Clin Pathol 1986;86:139–145.PubMedGoogle Scholar
  30. 30.
    Clement PB, Young RH: Atypical polypoid adenomyoma of the uterus associated with Turner’s syndrome. IntJ Gynecol Pathol 1987;6:104–113.CrossRefGoogle Scholar
  31. 30a.
    Lee KR: Atypical polypoid adenomyoma of the endometrium associated with adenomyomatosis and adenocarcinoma. Gynecol Oncol 1993;51: 416–418.PubMedCrossRefGoogle Scholar
  32. 30b.
    Staros EB, Shilkitus WF: Atypical polypoid adenomyoma with carcinomatous transformation: A case report. Surg Pathol 1991;4:157–166.Google Scholar
  33. 31.
    Friedler S, Margalioth EJ, Kafka I, Yaffe H: Incidence of post-abortion intra-uterine adhesions evaluated by hysteroscopy. A prospective study. HumReprod 1993;8:442–444.Google Scholar
  34. 32.
    Schenker JG, Margalioth EJ: Intrauterine adhesions: An updated appraisal. Fertil Steril 1982; 37:593–610.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Michael T. Mazur
    • 1
  • Robert J. Kurman
    • 2
    • 3
  1. 1.Crouse Irving Memorial Hospital, Health Science CenterState University of New YorkSyracuseUSA
  2. 2.Departments of Gynecology and Obstetrics and PathologyThe Johns Hopkins HospitalBaltimoreUSA
  3. 3.The Johns Hopkins University School of MedicineBaltimoreUSA

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